Clinical Significance Of Serum Hypoxia Inducible Factor-1α,Vascular Endothelial Growth Factor And Endothelin-1 In The Patients With Acute Coronary Syndrome

Objective:We detected the serum level of hypoxia - inducible factor - 1α(H IF - 1α),vascular endothelial growth factor(VEGF) and Endothelin-1(ET-1) in the patients with acute coronary syndrome(ACS) and stable angina pectoris, to find their relationship with the following facters:①their relationship with the stablebility of plaque in clinical studies;②their relationship of HIF-1α,VEGF and ET-1 in the expression of coronary atherosclerosis;③their relationship with the risk of MACE.Methods:The patients were chosen and divided into two group:acute coronary syndrome (ACS)group of 59 cases,stable angina pectoris (SAP)group of 28 cases.And the patient with ACS were divided into two sub groups: acute myocardial infarction (AMI) group (24 cases), unstable angina pectoris(UAP) group (35 cases). In addition,33 healthy cases were chosen as control group.Each subject was taken Coronary Artery Angiogram.Using 7-TIMI risk score as the quantitable indexes of the risk of MACE corresponding. The serum level of HIF-1α/VEGF were detected by ELISA and ET-1 detected by RIA in all the cases. Statistical evaluation was performed with 13.0 software.Before statistical evaluation,the normality and the homogeneity of variance of statistical data should be tested,Data were expressed as Mean±SD and compared by ANOVA,Differences among groups were analyzed by SNK-qtest,Correlation analysis was used by linear correlation analysis.Two-side P<0.05 was considered statistically significance.Results:1. The levels of HIF-1α/VEGFand ET-1 in ACS group were significantly higher than those in SAP and control groups [ ( 102.3±20.8) ng/ml,( 192.3±32.7) ng/ml,( 80.1±15.9) ng/ml and ( 41.5±21.4) ng/ml,( 121.0±22.3)ng/ml,( 45.1±13.3) ng/ml and ( 38.1±17.5) ng/ml,( 85.8±19.6) ng/ml,( 32.7±8.9) ng/ml] (P <0.05).2. There was no difference in HIF - 1αbetween SAP and control group (P >0.05), but VEGFand ET-1 in SAP group were higher than those in control group (P <0.05).3. The levels of HIF-1α,VEGF and ET-1 in AMI sub group were more than that of UAP sub group [ ( 127.6±23.4) ng/ml,( 231.5±39.2) ng/ml,( 92.3±17.4) ng/ml and ( 90.2±18.7) ng/ml,( 162.4±27.1)ng/ml,( 71.5±14.8) ng/ml] (P <0.05).4. There was a good relationship between HIF-1αand VEGF,HIF-1αand ET-1 during paticipating in coronary atherosclerosis;5. The risk score7-TIMI for subsequent cardiovascular events were increased in patients with higher serum level of MCP-1 and VEGF.Conclusions:1. The more severe ACS was, the higher level of serum HIF-1α,VEGF and ET-1 were. The elevation of HIF-1α,VEGF and ET-1 may be a sign of atherosclerotic plaque destabilization.2. The serum level of HIF- 1αwere positive correlated with that of VEGF and ET-1.3. The serum level of HIF-1α,VEGF and ET-1 were positive correlated with 7-TIMI risk score, It prompt that HIF-1α,VEGF and ET-1 was the reactiveness markers of coronary artery process.